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Friday, January 30, 2009

Boy's Club

Being a woman in medicine is not as difficult today as it was for our predecessors, but I'd venture to say that we still haven't gained true equality. My medical school class was the first class in school history to have an equal number of male and female students. The classes that followed ours actually were weighted in favor of more women than men. Yet, as I roam the halls of my hospital, I am acutely aware of how much of a "boy's club" still exists. There are small reminders in the physician's lounge areas of the surgical suites. The lounge attached to the female locker room is the "nurse's lounge." The lounge attached to the male locker room is the "doctor's lounge." In the hospital's general "doctor's lounge" there is a single restroom, in which the toilet seat is always left up.

In the operating room, invariably, it is my rooms that get the fresh new scrub techs that don't know a Kelly from a Heaney clamp, because they don't want to tick the male doctors off. My rooms also tend to run farther behind, "because (I) don't throw a fit." I'm sorry, since when was "throwing a fit" acceptable professional behavior? It happens more often than it should.

The reminders extend to the floor, as I round on my patients. At times I have to search high and low just to find the nurse that is taking care of my patient. I see my male colleagues, without lifting a finger, get a nurse to round with them. No kidding, these nurses, with whom I have a very good rapport and professional relationship, will snap to attention, grab the physician's charts, and follow them on rounds writing verbal orders as they go. Boggles the mind. I am friendly with the nurses, but in high stress times, I tend to bark orders just like any other physician. I have been called out for being "too harsh" in certain circumstances, and made to sit down with the nurse in question to apologize. I tread very carefully in my tone of voice, in order to not be misconstrued. In contrast, there was an incident in which a male physician grabbed a nurse and *shook* her because she did not complete an order that he requested (in the best interest of the patient.) Today that doctor and that nurse were laughing and joking together like it never happened. I have to wonder if I would even be working if I had dared pull such a stunt.

In the office, the fun continues, as my front office staff gives me hell for cancelling patients for a delivery, but will turn around in a heartbeat and croon "Aw, poor OtherDoc (my male colleague) has to go for a delivery. Of course we'll take care of it!" When the office orders lunch, they serve it to him in his office! You know, because he has "important doctor stuff to do!" Not to mention the varied and sundry insults that seem to happen on a daily basis. Patients that call me "sweetie" instead of *Dr.* Whoo or refer to me as "that nurse right there." Office patients that insist on calling me by my first name (which I never gave to them). The visitors that come up to me at the desk while I am working on charts to ask me to go fetch them some ice. This never happens to my male colleagues. It just doesn't.

We've all covered, in detail, how the difficulties extend into our home lives as we struggle to wear the mother, wife, and physician hats simultaneously. Women in medicine may have come a long way (baby), but from where I stand, we are the Thursday's children of medicine. We have far to go.

15 comments:

Interesting. As a resident I learned that becoming friends with nurses was strategy that worked for me. To be successful (i.e. getting prompt response to orders, expedient assistance at bedside and minimizing hassles) my attempts were to establish a team effort. If the the nurses and CNAs liked me and understood my genuine concern they would give respect and allow me to navigate for success.

I think many women in medicine do the same thing. Considering the majority of hospital/clinical staff are women, the female physician is seen as either an equal or adversary.

We have a ways to go - no doubt about it. Our hospital formed a leadership committee to get more input from physicians about how we feel the hospital needs to improve - initially the group was made of all male specialists who basically got to go to upscale dinners and talk. After I pointed out that no primary care or females were on the committee, I was invited to attend. They're kind of weird dinners where noone seems to have much passion for their concerns. Still, a lot of networking for our hospital goes on after hours with the guys - NFL games, tickets to this or that. In ten years, I've been given tickets to an event twice - both were fundraisers.

I know, I know. Everything you say is true. But things really are better than they were when I started 30 years ago. BUT: nurses are still malignant (boy, are they malignant), patients are still disrespectful and it's still just awful damn hard. I'm so glad neither of my daughters wanted to do medicine.

You are right about everything you said and your experience echos my own as a resident physician. Women are still not viewed as authority figures in our society and this translates to the disrespect we are given from our patients and staff and nurses. How silly, that as women, we literally have to try to be buddies with all the nurses in order to get them to do what we ask them. Or that when we are assertive, it is offensive. The position of women in society should improve as our culture evolves and gets more accustomed to women in authority positions. I look forward to a day when a female commander-and-chief of the country would not seem like a novel idea and we as women can hold our heads up high as the intelligent, skilled, talented professionals that we are.

Leastways, I don't get invitations to the hospital staff party anymore inviting "you and your wife." I went into practice in the same town where I did my residency, but at the first staff meeting I was still almost booted out by one of the medical auxilary ladies who thought I was somebody's wife, and "the meeting was supposed to be stag." My gentle old professor (who probalby saw this coming) was behind me in the sign up line and convinced her that there were some "does" on the staff now. This was in 1982.

You forgot to mention the patients who call you "Ms. Whoo" instead of "Dr. Whoo". I have never heard a male doc called "Mr. Healer" instead of "Dr. Healer". This happens to me several times daily. I try to ignore it.

"Nurses are malignant," said someone up there. I'd like to think that, as a nurse, I treat male and female docs equally. Do you all see a difference in the attitudes of younger vs. older nurses? Nurses with different levels of training? What can be done to change all this? I would like to see more collaboration between nursing and the docs, and riffs like this make that impossible.

Love the blog, guys. It's great to hear things from the MD point of view.

Yes, yes - particularly on the different ways anger is perceived when expressed by male and female physicians. I am also friendly with my staff, and with the nurses, and it generally works well - plus I prefer it - but I think people expect to feel nurtured by women and don't expect that from men, so if I'm not nurturing it's upsetting. And if I'm actually angry? Much worse.

As to how doctors, male or female, are addressed: I'm a middle aged woman. If a doctor calls me by my first name I call him or her by his or her first name. If I'm addressed as Ms. Patient then I address the doctor as Dr. Doctor.

Oh, Dr. Whoo. I know exactly what you're going through. I've had many of the same experiences. One of the more frustrating is when you're sitting at the nurses station doing chart work and you're sitting next to a male nurse. Then the patient or family member walks up and asks YOU for directions, ice, whatever.

Also, to address Anonymous at 12:50. I NEVER call patients by their first name, even when I know them personally. I have several patients call me by my first name or the Ms. title. My partner? Never.

I try really hard not to think about things like this because they make me so MAD!! And I've been pretty successful at it. Then something obviously unfair smacks me upside the head.

Maybe it will make you feel better to think about how while we lady (in my case almost) docs have to play buddy-buddy with the female support staff, the boy docs have to actively flirt with them in order to get what they want. I can tell you that's a chore I'd rather not have. I'd take playing buddy-buddy any day over that.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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